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目的应用微超声探头进一步研究内镜下食管静脉曲张结扎术(EVL)对食管静脉曲张的治疗效果及判断预后。方法对40例中、重度食管静脉曲张的患者行食管静脉曲张结扎术 ,治疗前及治疗后2、4、8、12周在胃镜检查的同时应用微超声探头(UMP)探测曲张静脉内径、食管深层静脉的扩张程度及有无交通支的建立。结果EVL前 ,UMP可以观察和测量食管可见的曲张静脉 ,还可探测到食管深层的曲张静脉及交通支。EVL后 ,UMP与胃镜观察到的结果一致 ,均表现为曲张静脉的回缩 ,但胃镜表现F0的7例患者有3例UMP探测到曲张静脉。食管壁纤维化于EVL术后2周时即出现并局限在食管粘膜浅层。侧枝循环于术后4周时开始建立 ,12周时程度最严重。结论胃镜下微超声探头检查是一种先进的诊断方法 ,集安全、简便、客观、准确、重复性好于一身 ,它可以比胃镜更客观准确地描述EVL前后曲张静脉及周围血管的闭塞和再扩张情况 ,从而准确地判断治疗的效果
Objective To further study the therapeutic effect and prognosis of esophageal varices by endoscopic esophageal varices ligation (EVL). Methods 40 patients with moderate or severe esophageal varices underwent esophageal varices ligation before treatment and at 2, 4, 8, and 12 weeks after gastroscopy in the application of micro-ultrasound probe (UMP) detection of varicose vein diameter, esophageal Deep venous expansion and the establishment of traffic support. Results Before the EVL, UMP could observe and measure the varicose veins visible in the esophagus, and also detect the deep varicose vein and traffic branch in the esophagus. After EVL, the results of UMP and gastroscopy were consistent, showing the varicosity of varicose veins, but in 7 cases of gastroscopy F0, 3 cases of varicocele were detected by UMP. Esophageal fibrosis occurs 2 weeks after EVL and is localized in the superficial esophageal mucosa. Collateral circulation began to be established 4 weeks after surgery, the most severe at 12 weeks. Conclusions Gastroscopic micro-sonography is an advanced diagnostic method. It is safe, simple, objective, accurate and reproducible. It can describe the occlusion of varicose veins and peripheral blood vessels before and after EVL more objectively and accurately than endoscopy Expansion, so as to accurately determine the effect of treatment